Remote activity monitoring for family caregivers of persons living with dementia: a mixed methods, randomized controlled evaluation.
Remote activity monitoring for family caregivers of persons living with dementia: a mixed methods, randomized controlled evaluation.
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DOI：
10.1186/s12877-021-02634-8
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发表时间：
2021-12-18
期刊：
影响因子：
4.1
通讯作者：
Peterson CM
中科院分区：
文献类型：
--
作者：
Gaugler JE;Zmora R;Mitchell LL;Finlay J;Rosebush CE;Nkimbeng M;Baker ZG;Albers EA;Peterson CM
本研究的目的是确定远程活动监测（RAM）系统是否有利于照顾者谁帮助亲属阿尔茨海默氏症或相关痴呆症（ADRD）住在家里。我们假设，在18个月内，随机分配到ADRD患者家中接受RAM技术的家庭将经历统计学显著性（p <0.05）：1）在管理其亲属痴呆症时，照顾者自我效能和能力感得到改善; 2）照顾者痛苦减少（例如，负担、角色束缚和抑郁）。采用嵌入式混合方法设计，其中179名痴呆症照顾者被随机分配接受RAM或不。在18个月的时间内，每两年对护理人员进行一次调查，以收集关于RAM效果的定量和定性数据。在18个月的数据收集期后，对30名护理人员进行了半结构化访谈，以更深入地探讨RAM如何以及为什么被认为是有帮助的。生长曲线模型显示RAM对痴呆照顾者的结果没有直接或适度的影响。定性数据揭示了一个复杂的利用过程中的RAM的护理环境/上下文的影响，以及ADRD的时间进展和发展轨迹。研究结果表明，需要制定更有效的机制，以匹配适当的技术与不同的需求和护理环境的人生活与ADRD及其照顾者。将专业护理管理与被动监测系统（如RAM）相结合的三元方法也可能提高潜在的益处。 ClinicalTrials.govNCT03665909，于2018年9月11日回顾性注册。在线版本包含补充材料，可通过10.1186/s12877-021-02634-8获得。
The goal of the present study was to determine whether a remote activity monitoring (RAM) system benefited caregivers who aided relatives with Alzheimer’s disease or related dementias (ADRD) living at home. We hypothesized that over 18 months, families randomly assigned to receive RAM technology in the home of the person with ADRD would experience statistically significant (p < .05): 1) improvements in caregiver self-efficacy and sense of competence when managing their relative’s dementia; and 2) reductions in caregiver distress (e.g., burden, role captivity, and depression). An embedded mixed methods design was utilized, where 179 dementia caregivers were randomly assigned to receive RAM or not. Caregivers were surveyed bi-annually over an 18-month period to collect quantitative and qualitative data on RAM’s effects. Semi-structured interviews with 30 caregivers were completed following the 18-month data collection period to explore more in-depth how and why RAM was perceived as helpful or not. Growth curve models showed no direct or moderation effect of RAM on dementia caregiver outcomes. The qualitative data revealed a complex utilization process of RAM influenced by the care environment/context as well as the temporal progression of ADRD and the caregiving trajectory. The findings suggest the need for developing more effective mechanisms to match appropriate technologies with the heterogeneous needs and care contexts of people living with ADRD and their caregivers. A triadic approach that incorporates professional care management alongside passive monitoring systems such as RAM may also enhance potential benefits. ClinicalTrials.govNCT03665909, retrospectively registered on 11 Sept 2018. The online version contains supplementary material available at 10.1186/s12877-021-02634-8.
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